11/29/2023 EnchantaVaughn Approved QMHPA arrived to the home for an individual session with Ms. Cosby. Upon arrival at the home, Ms. Cosby presented with positive affect evident by her facial expression and physical demeanor. QMHPA informed Ms. Cosby that this session was going to address her goal 1 and goal 2. Ms. Cosby did not present any symptoms of SI or HI at the time of the session being conducted. QMHPA began session by exploring Ms. Cosby’s emotional well-being. QMHPA reviewed interventions from the previous session and questioned Ms. Cosby about her interactions with her family members and members of the community. QMHPA educated Ms. Cosby on positive communication skills and encouraged Ms. Cosby to refrain from verbal and physical altercations with others. QMHPA explored with Ms. Cosby positive coping skills and encouraged Ms. Cosby to utilize deep breathing when upset. QMHPA explored conflict resolution skills and encouraged Ms. Cosby to review previous conflict and explore alternative ways to have handled that conflict that causes her to be depressed. Ms. Cosby actively participated throughout the session. While educating Ms. Cosby on positive communication skills, Ms. Cosby shared that she wanted to decrease her usage of profanity, but that it was difficult due to her using profanity for most of her life. Ms. Cosby identified coping skills, but shared that she does not back down from an altercation, especially if she feels that she is right. At the end of the session, Ms. Cosby appeared irritated while exploring conflict resolution and stated to QMHPA that there are a lot of things that she has to work on as an individual. She mentioned to QMHPA that when she is depressed she will engage in those type of behaviors and don’t care what anyone thinks about her.